CLINICAL USE

Analgesia and antipyretic

DOSE IN NORMAL RENAL FUNCTION

500 mg – 1 g every 4–6 hours(IV: if <50 kg, dose is 15 mg/kg)

PHARMACOKINETICS

  • Molecular weight                           :151.2
  • %Protein binding                           :20–30
  • %Excreted unchanged in urine     : <5
  • Volume of distribution (L/kg)       :1–2
  • half-life – normal/ESRD (hrs)      :1–4/Unchanged

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : Dose as in normal renal function
  • <10           : 500 mg – 1 g every 6–8 hours

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Not dialysed. Dose as in GFR <10 mL/min
  • HD                     :Dialysed. Dose as in GFR
  • <10           : mL/min
  • HDF/high flux   :Dialysed. Dose as in GFR
  • <10           : mL/min
  • CAV/VVHD      :Unknown dialysability. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs

  • None known

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral, rectal, IV

    Rate of Administration

    15 minutes

    Comments

    –

    OTHER INFORMATION

    Beware sodium content of soluble tablets (1 tablet ≡ 18.6 mmol sodium)Nephrotoxic in overdose due to a reactive alkylating metaboliteMetabolites may accumulate in CKD 5; normal doses are used in CKD 5IV preparation starts working within 5 to 10 minutes with peak activity after 60 minutes.

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